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Background

Malaria continues to be a major public health challenge, contributing to significant
healthcare burdens and a negative impact on the economic and social development of
affected countries [1]. With 20% mortality, malaria is Africa’s leading cause of death for children under
the age of 5 [1,2]. In Ghana, it is 50% with approximately 7.3 million cases a year [3,4]. Between 1985 and 2003, the incidence of malaria increased from 31-8% to 44.7% [2-4]. Despite efforts at early diagnosis and treatment, insecticide treated net (ITNs)
distribution, residual indoor and outdoor spraying; malaria remains a serious mortality
and morbidity outcome in Ghana [5-7].

This research hypothesized that there is little understanding and acceptance amongst
Ghanaians regarding the long and short term health effects in malaria vector transmission
therefore fundamental prevention efforts are difficult to institutionalize. This research
effort examined knowledge, attitudes and behaviors regarding malaria prevention and
intervention in Greater Accra in 2010 and 2011 in a Family Practice health clinic.
This work was based on the paramount belief that the effective containment of malaria
needs an integrated systems approach which can only happen when there is a significant
change in behaviors and belief systems [8].

Materials and methods

Patients from a family practice health clinic in Greater Accra, Ghana were surveyed
in 2010 and again in 2011. Utlizing social research methods individuals were asked
questions to determine their perceived risk of becoming infected with malaria and
their knowledge, attitudes and beliefs towards disease. Participants were selected
based on the criteria of being patients of the clinic, residents of Ghana and being
parents.

Results

In general participant responses indicated a good understanding of malaria transmission
and prevention but on average participants believed that malaria transmission was
inevitable suggesting that acceptance of prevention efforts is lacking. Males perceive
their risk to be slightly higher by 0.5 compared to females; Older age groups had
slightly higher perceived risks, with an increase of 0.2 for every seven years of
age and participant with higher levels of education perceived their risks to be lower
by 0.3 per every degree earned. As age increased, the number of modes of protection
increase. Participants were more open towards protection usage for children versus
themselves. However, participants indicated they owned nets, thought they were effective
but did not use them. Overall responses did not indicate a perceived need for systematic
protective products or action planning nor was there a belief real prevention efforts
by the government were taking place.

Conclusions

Findings from this work suggest that prevention efforts at the macro levels could
more effective if tied to the current individual belief systems regarding malaria.
Findings from this work suggest that the perception of malaria prevention is possibly
linked to the lack of consistent, systematic and in-depth education regarding the
disease and how it related to personal efficacy in which to effect change in one’s
own environment and with medically appropriate and safe repellent solutions.

References

Alilo M, Bygbjerg I, Breman J: Are multilateral malaria research and control programs the most suggessful? Lessons
from the past 100 years in Africa.